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Stretching the boundaries: suitability of an arteriovenous fistula in elderly patients on hemodialysis—a northern India experience

  • Nephrology - Original Paper
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Abstract

Purpose

Considering various factors, such as multiple co-morbidities, unsuitable vessels for access creation, non-maturation, vascular calcifications, the outcome of arteriovenous fistula (AVF) in the elderly population, may not be similar to the younger people. Our study aims to analyze the outcomes of AVF in elderly patients (> 65 year).

Methods

It was a prospective observational study. Patients of more than 65 years of age in whom AVF was created from January 2012 to December 2015 were included in the study. These patients were followed up for 4 years. The primary endpoint of our study was to assess primary and secondary patency rates.

Results

A total of 450 AVFs were included in the study. The mean age was 68.5 years. The most common site of AVF was radiocephalic (RCAVF) in 70% (n = 315), brachiocephalic (BCAVF) in 24% (n = 108) and basilic vein transposition (BVT) in 6% (n = 27). At 48 months, the primary patency rate of RCAVF, BCAVF, and BVT was 55%, 61.6%, and 60.4%, respectively. The commonest cause of access failure was thrombosis followed by non-maturation.

Conclusion

AVF remains the preferred vascular access for hemodialysis even in the elderly population. Failure to mature and thrombosis continue to be a concern with AVF. Location of the AV access does not seem to impact the long-term patency.

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Data availability

The data that support the findings of this study are available from the corresponding author, [Vinant Bhargava], upon reasonable request.

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Funding

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Authors and Affiliations

  1. Institute of Renal Science, Sir Gangaram Hospital, New Delhi, India

    Priti meena, Vinant bhargava, Sumit Sehrawat, Devinder Singh Rana, Anil Kumar Bhalla, Ashwani Gupta, Manish Malik, Anurag Gupta & Vaibhav Tiwari

Authors
  1. Priti meena
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  2. Vinant bhargava
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  3. Sumit Sehrawat
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  4. Devinder Singh Rana
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  5. Anil Kumar Bhalla
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  6. Ashwani Gupta
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  7. Manish Malik
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  8. Anurag Gupta
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  9. Vaibhav Tiwari
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Contributions

M drafted the manuscript, and VB assisted with data analysis; DS participated in design and oversight of the study, and was involved with data collection; AK participated in the design of the study, and was involved with data collection; AG and AG were involved with data collection, and assisted with data analysis; MM assisted with data analysis; SS participated in study design and performed the statistical analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Vinant bhargava.

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Conflict of interest

No potential competing interest was reported by the authors.

Ethical approval and consent to participate

The study was reviewed and approved by the institutional ethical review boards of Sir Ganga Ram Hospital, New Delhi, India.

Consent for publication

All study participants, or their legal guardian, provided written consent prior to study enrollment.

Geolocation information

The study was conducted in a tertiary care hospital at New Delhi, India (110060).

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meena, P., bhargava, V., Sehrawat, S. et al. Stretching the boundaries: suitability of an arteriovenous fistula in elderly patients on hemodialysis—a northern India experience. Int Urol Nephrol 54, 671–678 (2022). https://doi.org/10.1007/s11255-021-02941-4

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  • DOI: https://doi.org/10.1007/s11255-021-02941-4

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